title: Glasgow prognostic score as a prognostic factor in metastatic castration-resistant prostate cancer treated with docetaxel-based chemotherapy.
abstract: BACKGROUND
  The modified Glasgow Prognostic Score (mGPS), derived from C-reactive protein (CRP) and albumin levels, and the neutrophil-lymphocyte ratio (NLR) have demonstrated prognostic significance in a number of malignancies.
  
  
  METHODS
  Baseline mGPS and NLR were calculated in a prospective cohort of chemotherapy-naive patients with metastatic castration-resistant prostate cancer (mCRPC) (AT-101-CS-205 trial) who received docetaxel and prednisone ± AT101. Cox proportional hazards regression models estimated their effects on overall survival (OS).
  
  
  RESULTS
  Of 220 eligible patients, mGPS and neutrophil and lymphocyte counts were available for 184, 193, and 112 patients, respectively. Albumin (hazard ratio [HR], 0.28; 95% confidence interval [CI]: 0.14-0.56; P < .001) and CRP (HR, 1.22; 95% CI, 1.00-1.48; P = .048) were independently prognostic for OS. An association between mGPS and OS was found (HR, 1.87; 95% CI, 1.35-2.59; P < .001; median survival, 23.5 months at mGPS 0 vs. 9.8 months at mGPS 2). mGPS was significant after controlling for 3 previously published nomograms or NLR (P ≤ .001). NLR was not prognostic for OS (HR, 0.98; P = .91), and no association between mGPS and toxicity was noted.
  
  
  CONCLUSIONS
  Our results demonstrate the prognostic role of the mGPS in mCRPC over variables previously identified. mGPS is inexpensive, easily measured, and could be incorporated into routine clinical testing if our results are confirmed in a subsequent validation study. The utility of the NLR in mCRPC remains uncertain despite evidence in other malignancies.
authors.affiliation: Sydney Cancer Centre, Concord Repatriation General Hospital, Concord, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Linton
authors.forename: Greg
authors.initials: G
authors.lastname: Pond
authors.forename: Stephen
authors.initials: S
authors.lastname: Clarke
authors.forename: Janette
authors.initials: J
authors.lastname: Vardy
authors.forename: Matthew
authors.initials: M
authors.lastname: Galsky
authors.forename: Guru
authors.initials: G
authors.lastname: Sonpavde
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000077143:Docetaxel; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D056510:Position-Specific Scoring Matrices; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011379:Prognosis; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D013534:Survival; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D011241:Prednisone
keywords: Inflammation; Malignancy; Neutrophil-lymphocyte ratio; Prognosis; mGPS